Key result
Discontinuation of metronidazole in a 78-year-old male with metronidazole-induced encephalopathy resulted in clinical improvement and complete resolution of MRI lesions within 12 days.
Case Report (n=1)
No
Metronidazole-induced encephalopathy is a rare, reversible condition that requires high clinical suspicion and immediate drug withdrawal for complete resolution.
Prompt withdrawal may reverse metronidazole encephalopathy; single case leaves open generalizability and causality.
We discuss the clinical and imaging perspective in a case of a 78-year-old male who developed slurring of speech and ataxia acute in onset for the last 3 days. During his hospital stay, he developed multiple episodes of focal seizures without secondary generalization involving the angle of mouth on the right side. The patient had ataxia and positive cerebellar signs. In the past, the patient was treated for amoebic liver abscess and had undergone percutaneous aspiration of abscess. The patient was prescribed oral metronidazole and was discharged. This time, the patient underwent magnetic resonance imaging examination, which revealed lesion highly suggestive of metronidazole-induced encephalopathy. The offending drug was discontinued immediately after which the patient improved clinically. A follow-up scan was performed after 12 days and showed complete resolution of lesions.
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Dwivedi et al. (2013) conducted a case report in Metronidazole-induced encephalopathy (n=1). Metronidazole was evaluated on Resolution of clinical symptoms and MRI lesions. Discontinuation of metronidazole in a 78-year-old male with metronidazole-induced encephalopathy resulted in clinical improvement and complete resolution of MRI lesions within 12 days.
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